The Ancient History of Chinese Medicine Part One

By Robert L. Felt Co-author Understanding Acupuncture

Much of what is said about the origins of Chinese medicine is more legend than history. However, plentiful evidence begins with Chinese Stone Age civilization. Medical history begins in the era between 1500 and 1000 BCE, the Chinese Bronze Age, the Shang dynasty. In Shang China the dead were believed to influence the living but to depend on the living for their provisions. "Di," as the supreme or divine ancestor was known, provided good harvests and assistance in battle. Yet, only the king's ancestors were able to influence Di. Thus the king was also the chief diviner and used "oracle bones" to communicate with his ancestors and seek the cooperation of Di. Cattle bones, and later turtle shells, were drilled and heated. This caused cracks and the king or a diviner interpreted these cracks. Medical questions were among the more prominent requests.

Shang era medicine was not a system distinct from religion. Treatment was essentially propitiation and medicine had no distinct conceptual foundation. Because the hostility of a neglected ancestor could result in crop failure, a battlefield loss, or the offending descendant becoming ill, all these calamities were similarly treated. Thus, like combat and the harvest, medicine was a life-and-death matter that belonged to religion. Shang China's theory of nature attributed control of the harvest, illness, or personal outcomes to the supernatural. However, there were exceptions, and among these were notions that would become medicine in succeeding generations. Natural causes of disease were recognized, and questions as to whether it was "snow" or an "evil wind" that caused an illness are inscribed on oracle bones.

History in the modern sense begins in the Zhou dynasty around 722 BCE. The middle to late Zhou was a period of human ruthlessness. In the last years of the dynasty this reached the extreme, with the establishment of a "farm and fight" state. In this period medicine began to have an existence separate from ancestral propitiation and demonology. It was not yet distinct from religion in the social order, but there were, for example, four kinds of doctor listed in the Zhou archives: physicians, surgeons, dietitians, and veterinary surgeons. What we recognize today as Chinese medicine would not be clearly evident until the late Zhou and Qin dynasties. This period, known as the Warring States, would see almost continuous warfare ending in the cultural devastation of China's first emperor, Shi Huang-Di. He unified the empire, conceived and began the building of the great wall, and also ordered the destruction of all books on topics other than medicine, drugs, oracles, agriculture and forestry. Yet, despite the cultural destruction he ordered, the standardizations he imposed and the cities he commanded be built and populated would become the foundation of a cultural renaissance in the following Han dynasty of 206 BCE to 220 CE.

The Chinese celebrate the Han as a period of supreme cultural achievement worthy of emulation. Chinese culture, including medicine, changed with swiftness rarely found in Chinese history. Not only were cultural barriers eliminated, Chinese society and economy were physically accessible as never before. Roads and canals connected once largely isolated and autonomous cities, and all classes of society benefited from an ever-increasing wealth from trade and economic interdependence. At the very least, the court and the wealthy were able to obtain foreign goods. Feudal lords no longer controlled social and religious life, and an educated class arose and survived independent of their wealth or favor.

Han China was no longer isolated, and the Chinese reached outward in all directions. The famous Silk Road opened in the 1st century BCE during the reign of the Han emperor Wu-Di, and contact with Western Asia commenced. Medicine may also have been fertilized by foreign ideas, but this can be neither proven nor discounted. From the viewpoint of medicine generally, and acupuncture in particular, the Han was the period during which the medicine of systematic correspondence comes of age. The Ma Wang-Dui scripts of the late 3rd or early 2nd century BCE, the Huang Di Nei Jing (The Yellow Emperor's Canon of Internal Medicine) texts of the second to first century BCE, and the Nan Jing (The Canon of Difficult Issues) of the first century provide an historical window on this process. These documents trace over approximately 400 years the development of the major conceptual features of the medicine of systematic correspondence, the conceptual center of what we know as traditional Chinese medicine today. Thus, the theories of anatomy, physiology, pathology, and treatment that formed China's indigenous medicine to the present day matured during the Han. Although Zhang Zhong-jing's Shang Han Lun would describe a systematic ordering of natural drug therapy in this era, it would have little effect on Chinese medicine until nearly 1000 years had passed.

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